A Cross-Sectional Study on Post-Partum Severe Acute Maternal Morbidity And Maternal Deaths in A Tertiary Level Teaching Hospital of Eastern India

Abstract

Objectives: Identification of severe acute maternal morbidity (SAMM) has gained importance in recent years in view of falling maternal death rates and thrust on improving quality of maternal health care. Although most of these events occur in developing countries, reporting system for SAMM is poorly developed in these regions. Aim of this study was to determine the incidence and direct causes of postpartum SAMM along with measuring of relevant new indicators on maternal health in an apex institute of India Materials and Methods: Hospital based cross sectional study conducted in India on 109 women with severe post partum complications. Outcome measures were SAMM or death. Results: 99 women had SAMM and there were 10 maternal deaths. Eclampsia was the most common cause of SAMM, but case fatality ratio was higher for PPH. SAMM ratio was 16.22/1000 live births and mortality index was 9.17%. Conclusion: 1 out of every 10 women with SAMM dies in developing countries. Improving facility based care and prompt referral can be a short term measure to quickly reduce the number of maternal deaths. Facility based monitoring and reporting of severe maternal outcome is an important step for scaling up such efforts.

Analysis of maternal near miss at tertiary level hospitals, Ahmedabad: A valuable indicator for maternal health care

“…It was found to be lower than other studies which indicate the requirement of better referral services at our centers. [41314] In some studies, MNM ratio was found to be lower than the present study. [31516]…”

“…In the present study, near miss: death ratio was found somewhat similar to other studies,[51417] while in some other states, it was found to be higher. [41316] Higher near miss mortality ratio indicates a better quality of care at that facility. The present study has been done in a tertiary referral center covering most districts in and around Ahmedabad, with most of the cases being referred in an already moribund state, leading to less near miss and more of MD.…”

“…However, it was found to be lower in some states than the present study, which indicate more deaths of women at our study hospitals. [4131416] This might be due to the higher number of complicated cases being referred to the civil hospital, Ahmedabad, from the nearby states which eventually progresses to death during traveling or just after reaching the civil hospital, Ahmedabad. Identification of high-risk cases and timely and fast referral of high-risk patient and institutional delivery can prevent MNM and MD.…”

Maternal Near Miss in A Tertiary Care Hospital : An Observational Study

“…6,14,15 While in some other states, it was found to be higher. 7,16,17 Higher near miss : Mortality ratio indicate a better quality of care at that facility. Critical care facility in Chattogram Maa-O-Shishu Hospital (CMOSH) still needs further improvement.…”